| NPI | 1750793048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 557291) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13111340012) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 149634) | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2014-10-21 |